Key result
Multidisciplinary integrated care in AF cuts all-cause mortality ~48% and CV hospitalization vs usual care.
Why the study?
The study was conducted to assess the effectiveness of multidisciplinary integrated care on clinical outcomes in patients with atrial fibrillation.
Does a multidisciplinary integrated care approach reduce mortality and cardiovascular hospitalization in patients with atrial fibrillation?
Meta-Analysis
Does a multidisciplinary integrated care approach reduce mortality and cardiovascular hospitalization in patients with atrial fibrillation?
Effect estimate: OR 0.52 (95% CI 0.36-0.74)
p-value: p=0.0003
A multidisciplinary integrated care approach, including nurse-led care, significantly reduces all-cause mortality and cardiovascular hospitalization in patients with atrial fibrillation compared to usual care.
Supports multidisciplinary integrated care as standard for atrial fibrillation; confirms mortality benefit in Level 1 meta-analysis.
Objective: To assess the effectiveness of multidisciplinary integrated care in the clinical outcomes of atrial fibrillation patients. Methods: Medline, EMBASE, and the CENTRAL trials registry of the Cochrane Collaboration were searched for articles on multidisciplinary integrated care in atrial fibrillation patients. The systematic review and meta-analysis included six and five articles, respectively, that compared the outcomes between the integrated care group and control group. Results: Multidisciplinary integrated care was concomitant with a decrease in all-cause mortality (OR 0.52, 95%CI 0.36-0.74, P=0.0003) and cardiovascular hospitalization (OR 0.66, 95%CI 0.49-0.89, P=0.007). Multidisciplinary integrated care had no significant impact on major adverse cardiovascular event (MACE) (OR 0.76, 95%CI 0.37-1.53, P=0.44), cardiovascular deaths (OR 0.49, 95% CI 0.21-1.17, P=0.11), atrial fibrillation (AF)-related hospitalization (OR 0.76, 95%CI 0.53-1.09, P=0.14), major bleeding (OR 1.02, 95%CI 0.59-1.75, P=0.94), minor bleeding (OR 1.12, 95%CI 0.55-2.26, P=0.76), and cerebrovascular events (OR 0.72, 95%CI 0.45-1.18, P=0.19). Conclusion: In comparison to usual care, a multidisciplinary integrated care approach (i.e., nurse-led care along with usual specialist care) in AF patients is associated with reduced all-cause mortality and cardiovascular hospitalization.
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Khan et al. (2022) conducted a meta-analysis in atrial fibrillation. Multidisciplinary integrated care vs. usual care was evaluated on all-cause mortality (OR 0.52, 95% CI 0.36-0.74, p=0.0003). Multidisciplinary integrated care in atrial fibrillation patients reduced all-cause mortality (OR 0.52; 95% CI 0.36-0.74; P=0.0003) and cardiovascular hospitalization compared to usual care.
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